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Monitoring System Certification <br />Site Address: '5469: 130 S WILSON WAY, STOCKTON, CA 95205 <br />D. Results of Testuig/Servicing <br />Software Version Installed: . l� <br />Comulete the followine checklist: <br />Date of TestingJServicing: � V z � -�`.� <br />rf Yes <br />No* <br />Is the audible alarm operational? <br />No* <br />Is the visual alarm o erational? <br />reyoe <br />No* <br />Were all sensors visuallins ected, function alltested, and confirmed o esational? <br />No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br />not interfere with their proper operation? <br />Yes <br />No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />Ir <br />NIA <br />operational? <br />Yes <br />No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />a NIA <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate <br />positive shut -down? (Check all that apply)S_ mp/Trench Sensors;)t§,Zispenser Containment Sensors. <br />Did you corfirmpositive shut -down due to leaks armed. sensor failureldisconnection es; ONO. <br />Yes <br />Y No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />NIA <br />mechanical overfill prevention valve is installed), is the ove&JI warning alarm visible and audible at the tank <br />3CG' <br />O <br />fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? ....9'a <br />s* <br />A No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br />and list the manufacturer name and mo del for allre lacement arts in Section F, below. <br />[] Yes* <br />• No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all fiagrply)n <br />Product; M Water. If res, describe causes in Section E, below. <br />Yes <br />No* <br />Was monitoring system set-up reviewed to ensure proper settings? <br />[] No* <br />Is all monitoring a ui mentoperational per manufacturer's s ecifications? <br />* In Sec6ox E below, descrbe kow and when these deficiencies were or will be corrected. <br />E. Comments: <br />Page 2 of 3 03M 1 <br />